Alpha-gal Allergy in a 6-Year-Old Male: A Case Report

Kinoshita, Masanosuke; Newton, Samuel S.

doi:10.31729/jnma.4557

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…GI-isolated alpha-gal allergy in children is likely underdiagnosed and has been rarely reported. A case report describes a 6-year-old boy from Missouri who presented to his pediatrician with abdominal pain and changes in bowel habits for 3 weeks, but alpha-gal allergy was not diagnosed until 11 months later, when he had urticaria hours after eating hamburger 20 . In a retrospective cohort of 42 alpha-gal allergic children in Missouri, most (78.0%) had a prior diagnosis of allergic rhinitis, eczema, or asthma, and the most common presenting symptoms were urticaria (78.0%), anaphylaxis (29.3%) angioedema (21.9%), and GI distress (17.0%) 21 …”

Section: Discussionmentioning

confidence: 99%

“…A case report describes a 6-year-old boy from Missouri who presented to his pediatrician with abdominal pain and changes in bowel habits for 3 weeks, but alpha-gal allergy was not diagnosed until 11 months later, when he had urticaria hours after eating hamburger. 20 In a retrospective cohort of 42 alpha-gal allergic children in Missouri, most (78.0%) had a prior diagnosis of allergic rhinitis, eczema, or asthma, and the most common presenting symptoms were urticaria (78.0%), anaphylaxis (29.3%) angioedema (21.9%), and GI distress (17.0%). 21 The delayed nature of alpha-gal reactions may make diagnosis of GI-isolated alpha-gal particularly challenging for patients, parents, and physicians, though GI-isolated patients did react more quickly than patients with systemic symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal-isolated Distress is Common in Alpha-gal Allergic Patients on Mammalian Meat Challenge

McGill¹,

Levin

Shaheen³

et al. 2023

Journal of Clinical Gastroenterology

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Background and Aims: Alpha-gal allergy causes a delayed reaction to mammalian meats and has been reported worldwide. Patients with the allergy may present with isolated gastrointestinal (GI) symptoms, but this phenotype is poorly understood. Methods:We pooled and analyzed symptoms and demographics of patients from two prospective cohorts of patients with a diagnosis of alpha-gal allergy who reacted after eating mammalian meat under observation. We compared the characteristics of patients who demonstrated GI-isolated symptoms on a challenge with those who exhibited symptoms outside the GI tract (skin, respiratory, and circulatory).Results: Among the 91 children and adult alpha-gal allergic patients who exhibited symptoms after oral challenge with mammalian meat, 72.5% experienced GI distress with one or more GI symptoms, which was the most frequent class of symptoms, compared with skin changes in 57.1% and respiratory distress in 5.5%. The most common GI symptoms were abdominal pain (71%) and vomiting (22.0%). GI-isolated symptoms occurred in 37 patients (40.7%) who reacted, and those patients reacted more quickly than patients who exhibited systemic symptoms (median onset of symptoms in GI-isolated group 90 min vs 120 min) and were more likely to be children than adults (relative risk = 1.94, 95% CI: 1.04-3.63).Conclusions: Isolated-GI distress occurred in 4 in every 10 alpha-gal allergic individuals who developed symptoms on oral food challenge with mammalian meat. Alpha-gal allergic patients, particularly children, may exhibit GI distress alone, and adult and pediatric gastroenterologists should be aware of the diagnosis and management of the allergy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gastrointestinal-isolated Distress is Common in Alpha-gal Allergic Patients on Mammalian Meat Challenge

McGill¹,

Levin

Shaheen³

et al. 2023

Journal of Clinical Gastroenterology

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“…Alpha-gal allergy is an emerging clinical syndrome, first described in the 2000s, that can cause gastrointestinal (GI) distress, hives, angioedema, and anaphylaxis hours after ingestion of pork, beef, and other mammalian meat or meat-derived products (1). Various publications in the allergy, GI, and general medicine literature have described patients with the allergy who present with GI-isolated symptoms without typical allergic symptoms such as angioedema or hives (2–8). Here, we aim to inform gastroenterologists on how to diagnose and manage alpha-gal allergy.…”

mentioning

confidence: 99%

Suddenly Steakless: A Gastroenterologist's Guide to Managing Alpha-Gal Allergy

McGill

Richards²,

Commins

2022

Am J Gastroenterol

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Alpha-Gal Syndrome in Children: Peculiarities of a “Tick-Borne” Allergic Disease

et al. 2021

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The alpha-gal syndrome is an allergic syndrome that comprises two clinical pictures: an immediate hypersensitivity to drugs containing alpha-gal and a delayed hypersensitivity to the ingestion of red mammalian meat. This allergic syndrome is often under-recognized, and patients are mislabeled with diagnosis as spontaneous urticaria or idiopathic anaphylaxis. Even though less frequently, children could also be of interest, especially in tick-endemic areas. In most cases, a positive anamnesis for tick bites months before the onset of symptoms is recorded. The clinical manifestations could range from asymptomatic cases to severe anaphylaxis. The most frequently used diagnostic test is the determination of specific IgE for alpha-gal. Oral provocation test is usually reserved to unclear cases or to verify tolerance after diet. No long-term follow-up studies have been published, although an elimination diet could lead to a decrease of specific IgE for alpha-gal and a possible reintroduction of some avoided foods. This paper provides a literature review, focused on pediatric age, and an evaluation of available diagnostic tests. We analyze the correlation between tick bites and symptom onset and unfold the different clinical pictures to help clinicians to promptly recognized this syndrome. Lastly, we address unmet needs in this specific allergy.

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Alpha-gal Allergy in a 6-Year-Old Male: A Case Report

Cited by 3 publications

References 5 publications

Gastrointestinal-isolated Distress is Common in Alpha-gal Allergic Patients on Mammalian Meat Challenge

Gastrointestinal-isolated Distress is Common in Alpha-gal Allergic Patients on Mammalian Meat Challenge

Suddenly Steakless: A Gastroenterologist's Guide to Managing Alpha-Gal Allergy

Alpha-Gal Syndrome in Children: Peculiarities of a “Tick-Borne” Allergic Disease

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